Thank you for taking the time to fill out CynTech Boxers Perm. Reg'd questionnaire.
This questionnaire may seem long but the information I receive from it will help me determine if a dog/puppy from CynTech Boxers Perm. Reg'd is suited to your lifestyle
and expectations. Please make sure that you have answered all questions that apply to you honestly and thoroughly. Any incomplete questionnaire will not be considered.

If your browser does not support this form, please copy all questions that apply and send by email to: cyntechboxers@shaw.ca

Once I have received your completed questionnaire, I will go through it, contact you with any other questions I may have (please note that it may take a few days
before I get back to you and I thank you for your patience), and if the questionnaire is completed to my satisfaction, I will place you on my waiting list. Please note that
being placed on my waiting list does not guarantee you a dog or puppy.

If I do not have a puppy for you, I will refer you to reputable breeders that may have an upcoming litter.

Personal & Family Information:

Your full name (first/last):

Your email address:

Webpage (if you have one):

Address:

City:

Province/State:

Postal/Zip Code:

Country:

Home Phone:

Alternative Phone:

Fax:

Occupation:

Name of Employer:

Do you work full or part time?

Do you have any children living in the home?

If yes please list their ages.

Have the children been raised with a dog or any other pet?

Have you ever owned a Boxer?

For how long?

Do you still have your Boxer?

If no please explain what happened to your Boxer (ie. died, cause of death, given away, placed, lost, stolen, etc.).

Do you currently or previously owned another breed of dog?

If yes please list each breed, the age, if alive or deceased (include cause of death), if spayed, neutered or intact.

Do you own a cat?

If yes how many?

Is the cat (or cats) declawed?

Do you have any other type of pet?

If yes what type of pet?

If you currently have a pet (or pets), is it spayed or neutered?

If no please explain why.

Housing Information:

What type of dwelling do you live in?

If other dwelling please specify.

How long have you lived at current address?

At your current address do you?

If you lease or rent does your agreement allow you to have pets?

If your lease or rental agreement allows pets, are there any restrictions (ie. size of dog, number of pets, etc.)?

What are the restrictions?

Landlord's name (if leasing or renting):

Landlord's phone number (if leasing or renting):

Do you have a fenced yard?

What type of fencing do you have?

Specify your "other" type of fencing:

Specify the height of the fence:

If you don't have a fence how will you exercise your Boxer and how often?

Do you have an outdoor kennel or run?

Do you have a doggy door?

Dog/Puppy Care & Training Info:

In addition to the purchase price of your Boxer and the basic supplies (collar & leash, bedding, crate, dish, etc.), are you financially able to (check all that apply):